Article 1321

Title of the article

Coronavirus infection and cardiovascular system damage: clinical and preclinical manifestations (a review of literature) 


Irina V. Avdeeva, Candidate of medical sciences, associate professor of the sub-departmen of therapy, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: 

Index UDK





The COVID-19 (COronaVIrus Disease-2019) pandemic caused by a new coronavirus has become a real challenge for the healthcare system around the world. Despite the high tropism of the virus to the respiratory organs (pneumonia, respiratory distress syndrome), it quickly became clear that the lesion is not limited only to the lungs, but there is a risk of exacerbation of all chronic diseases and the development of polyorgan failure in later stages, the entire cardiovascular system is affected with direct and indirect damage to other organs dependent on it. The great importance in the pathogenesis of the disease is the renin-angiotensin-aldosterone system disruption, the endothelium involvement in the pathological process, which, of course, will affect the structural and functional properties of the arterial wall. In addition, the assessment of biochemical markers for identifying the degree of damage to the cardiovascular system both in the acute and in the delayed period is of considerable interest. 

Key words

COVID-19, arterial stiffness, cardiovascular diseases, biomarkers 

Download PDF

1. Shlyakhto E.V., Konradi A.O., Arutyunov G.P. [et al.] Guidelines for the diagnosis and treatment of the circulatory system’s diseases during the COVID-19 pandemic. Rossiyskiy kardiologicheskiy zhurnal = The Russian cardiological journal. 2020;25(3):1–20. (In Russ.)
2. Guzik T.J., Mohiddin S.A., Dimarco A. [et al.]. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovascular Research. 2020;116(10):1666–1687.
3. Williams B., Mancia G., Spiering W. [et al.]. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal. 2018;39(33):3021–3104.
4. Boytsov S.A. Vessels as a springboard and target of arterial hypertension. Aktual'nye voprosy bolezney serdtsa i sosudov = Actual issues of heart and vascular diseases. 2006;1(3):35–40. (In Russ.)
5. Tipnis S.R., Hooper N.M., Hyde R. [et al.]. A human homolog of angiotensinconverting enzyme. Cloning and functional expression as a captoprilin sensitive carboxypeptidase. Journal of Biological Chemistry. 2000;275(43):33238–33243.
6. Zhang H., Penninger J.M., Li Y. [et al.]. Angiotensinconverting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Medicine. 2020;46(4):586–590.
7. Monteil V., Kwon H., Prado P. [et al.]. Inhibition of SARS-CoV-2 Infections in engineered human tissues using clinical-grade soluble human ACE2. Cell. 2020;181(4):905–913.
8. Thomas M.C., Pickering R.J., Tsorotes D. [et al.]. Genetic Ace2 deficiency accentuates vascular inflammation and atherosclerosis in the ApoE knockout mouse. Circulation Research. 2010;107(7):888–897.
9. Wu C., Chen X., Cai Y. [et al.]. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Internal Medicine. 2020;180(7):934–943.
10. Kumar S., Kumar N., Kumar A. [et al.] The COSEVAST Study: Unravelling the role of Arterial Stiffness in COVID-19 Disease severity. British Medical Journal Yele. Available at: (accessed 01.04.2021).
11. Shridhar Y., Naidu M.U., Usharani P., Raju Y.S. Non- invasive evaluation of arterial stiffness in patients with increased risk of cardiovascular morbidity: A cross sectional study. Indian Journal of Pharmacology. 2007;39:294–298.
12. Schnaubelt S., Oppenauer J., Tihanyi D. [et al.]. Arterial stiffness in acute COVID‐19 and potential associations with clinical outcome. Journal of internal Medicine. Available at: (accessed 01.04.2021).
13. Bruno R.M., Spronck B., Hametner B. [et. al.]. Covid-19 Effects on ARTErial StIffness and Vascular AgeiNg: CARTESIAN Study Rationale and Protocol. Available at: (accessed 01.04.2021).
14. Avdeeva I.V., Burko N.V., Kvasova O.G., Aryasova T.A. Early vascular aging syndrome: pathogenesis and possibilities of drug correction. Vrach = The Doctor. 2019;30(12):10–13. (In Russ.)
15. Laurent S., Boutouyrie P., Cunha P.G. [et al.]. Concept of extremes in vascular aging. Hypertension. 2019;74:218-28.
16. Varga Z., Flammer A.J., Steiger P. [et al.]. Endothelial cell infection and endotheliitis in COVID‐19. The Lancet. 2020;395:1417–1418.
17. Mehta P., McAuley D.F., Brown M. [et al.]. COVID‐19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020;395:1033–1034.
18. Verdoni L., Mazza A., Gervasoni A. [et al.]. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. The Lancet. 2020;395:1771–1778.
19. Zanoli L., Briet M., Empana J.P. [et al.]. Vascular consequences of inflammation: a position statement from the ESH Working Group on Vascular Structure and Function and the ARTERY Society. Journal of Hypertension. 2020;38:1682–1698.
20. Corrales-Medina V.F., Alvarez K.N., Weissfeld L.A. [et al.]. Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. JAMA. 2015;313(3):264–274.
21. Roman M.J., Devereux R.B., Schwartz J.E. [et al.]. Arterial stiffness in chronic inflammatory diseases. Hypertension. 2005;46(1):194–199.
22. Nagayama D., Imamura H., Endo K. [et al.]. Marker of sepsis severity is associated with the variation in cardio-ankle vascular index (CAVI) during sepsis treatment. Vascular Health and Risk Management. 2019;15:509–5016.
23. Pleiner J., Heere‐Ress E., Langenberger H. [et al.]. Adrenoceptor hyporeactivity is responsible for Escherichia coli endotoxin‐induced acute vascular dysfunction in humans. Arteriosclerosis Thrombosis and Vascular Biology. 2002;22(1):95–100.
24. Piepoli M.F., Hoes A.W., Agewall S. [et al.]. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal. 2016;37(29):2315–2381.
25. Gennaro Mazza M., De Lorenzo R., Conte C. [et al.]. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behaviour and Immunity. 2020;89:594–600.
26. Walczewska J., Rutkowski K., Wizner B. [et al.]. Stiffness of large arteries and cardiovascular risk in patients with post-traumatic stress disorder. European Heart Journal. 2011;32(6):730–736.
27. Hendren N.S., Drazner M.H., Bozkurt B., Cooper L.T. Description and proposed management of the acute COVID19 cardiovascular syndrome. Circulation. 2020;141(23):1903–1914.
28. Hendren N.S., Grodin J.L., Drazner M.H. Unique patterns of cardiovascular involvement in COVID-19. Journal of Cardiac Failure. 2020;26(6):466–469.
29. Oudit G.Y., Kassiri Z., Jiang C. [et al.]. SARS-coronavirus Modulation of Myocardial ACE2 Expression and Inflammation in Patients With SARS. European Journal of Clinical Investion. 2009;39(7):618-25.
30. Cooper L.T.Jr. Myocarditis. New England Journal of Medicine. 2009;360(15):1526–1538.
31. Sardu C., Gambardella J., Morelli M.B. [et al.]. Hypertension, thrombosis, kidney failure, and diabetes: Is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basic evidence. Journal of Clinical Medicine. 2020;9(5):1417.
32. Tang N., Li D., Wang X., Sun Z. Abnormal Coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis. 2020;18(4):844–847.
33. Grimaud M., Starck J., Levy M. [et al.]. Acute myocarditis and multisystem inflammatory emerging disease following SARS-CoV-2 infection in critically ill children. Annals of Intensive Care. 2020;10(69):69–72.
34. Barbarash O.L., Karetnikova V.N., Kashtalap V.V. [et al.]. New coronavirus disease (COVID-19) and cardiovascular disease. Kompleksnye problemy serdechno-sosudistykh zabolevaniy = Complex problems of cardiovascular diseases. 2020;9(2):17–28. (In Russ.)
35. Huang C., Wang Y., Li X. [et al.]. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395:497–506.
36. Polonskaya Ya.V., Kashtanova E.V., Stakhneva E.M. [et al.]. COVID-19 and cardiovascular diseases. Ateroskleroz = Atherosclerosis. 2020;16(2):73–79. (In Russ.)
37. He X., Yao F., Chen J. [et al.]. The poor prognosis and influencing factors of high Ddimer levels for COVID-19 patients. Scientific reports. Available at: https://www. (accessed 01.04.2021).
38. Guo T., Fan Y., Chen M. [et al.]. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiology. 2020;5(7):811–818.
39. Hui H., Zhang Y., Yang X. [et al.]. Clinical and radiographic features of cardiac injury in patients with 2019 novel coronavirus pneumonia. British Medical Journal Yele. Available at: (accessed 01.04.2021).
40. Gao L., Jiang D., Wen X.-S. [et al.]. Prognostic value of NT-proBNP in patients with se-vere COVID-19. Respiratory Research. 2020;21(1):83.
41. Caro‐Codón J., Rey J. R., Buño A. [et al.]. Characterization of NT‐proBNP in a large cohort of COVID‐19 patients. Electronic text. European Journal of Heart Failure. Available at: (accessed 01.04.2021).


Дата создания: 23.11.2021 10:40
Дата обновления: 25.11.2021 13:31